Healthcare Provider Details

I. General information

NPI: 1720154719
Provider Name (Legal Business Name): NORRIS D. DUPREE JR. MFT, PSYCH., LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 ODDIE BLVD B
SPARKS NV
89431-1269
US

IV. Provider business mailing address

1555 ODDIE BLVD B
SPARKS NV
89431-1269
US

V. Phone/Fax

Practice location:
  • Phone: 775-359-9200
  • Fax:
Mailing address:
  • Phone: 775-359-9200
  • Fax: 775-359-9205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number01081
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number0000076723
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1085
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: